Brief Surgical Procedure Code Lists for Outcomes Measurement and Quality Improvement in Resource-Limited Settings

Conditions amenable to surgery represent a significant portion of the burden of disease worldwide, accounting for 10% of deaths and 14% of disability-adjusted life years lost. Today, however, over five billion people worldwide lack access to safe, timely, and affordable surgical care, and the outcomes experienced by surgical patients are least understood in low- and middle-income countries (LMICs). An important barrier to improving access to and quality of surgical care in resource-poor settings is the dearth of reliable data, due in part to the lack of a standardized system for classifying surgical procedures. The applicability of existing procedure coding systems in LMIC hospital settings is limited by their size, complexity, and cost of implementation. The coding of surgical procedures has been a particular challenge in Uganda and at Mbarara Regional Referral Hospital (MRRH), a 323-bed hospital and one of the country’s busiest surgical centers. A brief procedure code list could improve data collection for administrative, quality improvement, and research purposes at MRRH and in other resource-limited settings. Here, we describe the creation and validation of three abbreviated su